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General NPI Number Information
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NPI Number | 1922403773
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Entity Type | Organization
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Legal Business Name | LUQUILLO MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | #159 CALLE 14 DE JULIO
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City | LUQUILLO
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State | PR
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Zip | 00773
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Country | US
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Telephone | 787-500-7753
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Fax | 787-500-7754
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Provider Business Mailing Address
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Address Line | PO BOX 1515
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City | RIO GRANDE
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State | PR
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Zip | 00745-1515
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Country | US
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Telephone | 787-500-7753
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Fax | 787-500-7754
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Authorized Official
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Title or Position | DIRECTOR MEDICO
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Name | DR. JOSE R PENA FIGUEROA
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Credential | MD
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Telephone | 787-500-7752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 950313
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License Number State | PR
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